血清miR-181c-5p和miR-582-5p水平在老年急性缺血性脑卒中早期诊断中的应用

Application of serum miR-181c-5p and miR-582-5p levels in the early diagnosis of elderly acute ischemic stroke

目的探讨血清miR-181c-5p、miR-582-5p在老年急性缺血性脑卒中(AIS)早期诊断中的应用。方法选取2019年3月至2021年3月成都市第六人民医院神经内科治疗的89例老年AIS患者为AIS组,根据NIHSS评分将患者分为重度组24例、中度组34例、轻度组31例。另选取同期到本院就诊并确诊为无神经功能障碍、无梗死病灶的一般脑血管疾病患者60例为对照组。采用qRT-PCR检测血清miR-181c-5p、miR-582-5p表达水平;Spearman法分析老年AIS患者血清miR-181c-5p、miR-582-5p水平与NIHSS评分的相关性;Logistic回归分析老年AIS发生的影响因素;ROC曲线分析血清miR-181c-5p、miR-582-5p水平对老年AIS的诊断价值。结果与对照组相比,AIS组血清miR-181c-5p显著升高(P<0.05),血清miR-582-5p显著降低(P<0.05)。老年AIS患者血清miR-181c-5p水平与NIHSS评分呈正相关(r=0.676,P<0.001),血清miR-582-5p水平与NIHSS评分呈负相关(r=-0.656,P<0.001);随病情程度增加,血清miR-181c-5p水平逐渐升高,miR-582-5p水平逐渐降低(P<0.05)。miR-181c-5p是影响老年AIS发生的危险因素,miR-582-5p是保护因素(P<0.05)。血清miR-181c-5p、miR-582-5p以及两者联合诊断老年AIS的AUC分别为0.893、0.803、0.938,联合诊断的敏感度为88.80%,特异性为85.00%,两者联合优于血清miR-181c-5p、miR-582-5p各自单独诊断(P=0.022、P<0.001)。结论老年AIS患者血清miR-181c-5p水平上调,miR-582-5p水平下调,为早期诊断老年AIS及判断病情严重程度的标志物,两者联合诊断老年AIS具有较高效能。

Objective To explore the application of serum microRNA 181c-5p(miR-181c-5p)and microRNA 582-5p(miR-582-5p)in the early diagnosis of elderly acute ischemic stroke(AIS).Methods 89 elderly AIS patients admitted to the Department of Neurology of Chengdu Sixth People's Hospital from March 2019 to March 2021 were selected as the AIS group.According to the NIHSS score,patients were divided into severe group(24 cases),moderate group(34 cases),and mild group(31 cases).Another 60 patients with general cerebrovascular diseases who visited our hospital during the same period and were diagnosed with no neurological dysfunction or infarction were selected as the control group.QRT PCR was applied to detect the expression levels of serum miR-181c-5p and miR-582-5p.Spearman method was used to analyze the correlation between the serum levels of miR-181c-5p,miR-582-5p and NIHSS scores in elderly AIS patients.Logistic regression was applied to analyze the influencing factors of elderly AIS occurrence.ROC curve was adopted to analyze the diagnostic value of serum miR-181c-5p and miR 5825p levels for elderly AIS.Results Compared with the control group,the serum miR-181c-5p in the observation group was significantly increased(P<0.05),while the serum miR 5825p was significantly reduced(P<0.05).The serum miR-181c-5p level in elderly AIS patients was positively correlated with NIHSS score(r=0.676,P<0.001),while the serum miR 5825p level was negatively correlated with NIHSS score(r=-0.656,P<0.001).As the severity of the disease increased,the serum miR-181c-5p level gradually increased,while the miR-582-5p level gradually decreased(P<0.05).miR-181c-5p was a risk factor for the occurrence of AIS in the elderly,while miR-582-5p was a protective factor(P<0.05).The AUC of serum miR-181c-5p,miR-582-5p,and their combination in the diagnosis of elderly AIS was 0.893,0.803,and 0.938 respectively.The sensitivity and specificity of the combined diagnosis were 88.80%and 85.00%.The two-combined diagnosis was superior to the individual diagnosis of serum miR-181c-5p and miR-582-5p(P=0.022,P<0.001).Conclusion The serum level of miR-181c-5p in elderly AIS patients is upregulated,while the level of miR-582-5p is downregulated,which makes them biomarkers for early diagnosis of elderly AIS and judgment of disease severity.The two-combined diagnosis has high efficacy in diagnosing elderly AIS.